How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $489.78 | Facility | None | $112.20 | $112.20 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $457.09 | Professional | None | $112.20 | $112.20 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $457.09 | Facility | None | $199.53 | $251.19 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $269.15 | Professional | None | $102.33 | $123.03 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $85.11 Typical High $112.20 | Professional | UE · Used equipment | $77.62 | $85.11 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $269.15 | Facility | None | $134.90 | $199.53 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $363.08 | Professional | None | $173.78 | $239.88 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $165.96 | Professional | None | $89.13 | $123.03 | $165.96 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $338.84 | Professional | None | $213.80 | $218.78 | $338.84 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Facility | None | $63.10 | $128.82 | $275.42 |
United Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $151.36 | Professional | None | $70.79 | $102.33 | $151.36 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $223.87 | Professional | 52 · Reduced service | $56.23 | $56.23 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $91.20 | Professional | 53 · Discontinued | $22.39 | $22.39 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $67.61 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $45.71 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $16.22 | Professional | RR · Rental | $12.30 | $12.30 | $16.22 |
Where Ohio sits
The same service costs 3.9 times more in Kansas than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 42nd of 51
$112
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.